In contrast to other leading causes of death, the overall cancer mortality rate in the United States has dropped by 27 percent over a 25-year period, according to the American Cancer Society’s (ACS) latest annual report.

With this figure in mind, it is estimated that between 1991 and 2016 there were about 2,600,000 fewer cancer deaths in the country than there would have been if cancer mortality rates had remained the same.

In 1991, the U.S. cancer death rate was 215.1 per 100,000 people, data from the study shows. But this dropped steadily by around 1.5 percent per year to a rate of 156.0 per 100,000 people in 2016. Basing their findings on this this trend, the authors estimated that there would be 1,762,450 new cancer cases and 606,880 cancer deaths in 2019.

The gradual decline in the number of cancer deaths is largely being driven by “reductions in smoking, but also reflects improvements in treatment for most cancers and earlier detection through screening for some cancers (e.g., breast, cervix, colorectal)” Rebecca Siegel, from the ACS, told Newsweek.

Notably, the report highlighted declines in the four most common types of cancer: lung, breast, prostate and colorectal. For example, the prostate cancer death rate fell 51 percent from 1993 to 2016. Female breast cancer mortality dropped 40 percent from 1989 to 2016. Between 1990 and 2016, lung cancer death rates declined 48 percent for men.

Death rates for certain less common cancers rose between 2012 and 2016. These include cancers of the liver, pancreas, brain, nervous system, soft tissue—including the heart—and areas of the body affected by the human papillomavirus, such as the mouth and throat.

The report also noted how an individual’s socioeconomic status and ethnicity could significantly affect the chance of dying from the most preventable cancers. For example, lung and liver cancer death rates were more than 40 percent higher in men living in poor counties compared with their counterparts in more affluent counties. Similarly, the cervical cancer death rate for women living in poor counties was about double that of those in affluent counties.

“These [poor] counties are low-hanging fruit for locally focused cancer control efforts, including increased access to basic health care and interventions for smoking cessation, healthy living, and cancer screening programs,” the authors wrote in the study. “A broader application of existing cancer control knowledge with an emphasis on disadvantaged groups would undoubtedly accelerate progress against cancer.”

While mortality disparities when defined by race are narrowing, there is still a long way to go before Americans of different ethnicities are on a level playing field when it comes to this issue.

“Racial disparities largely reflect the disproportionate burden of poverty among blacks,” Siegel said. “Poor people have a higher prevalence of cancer risk factors, like smoking and obesity, as well as less access to high-quality cancer prevention, early detection, and treatment.”

According to the report, the number of women developing cancer has remained relatively stable over the last decade for which there is available data (2006-2015). Among men, there has been about a 2 percent decline in cancer incidence every year within the same period.

The study also found that in 2016, cancer was responsible for 22 percent of all deaths—meaning it was second only to heart disease in that year as a leading killer of American men and women.

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